| NPI | 1578978672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2602022) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2026-04-08 |